Entries in Breathing
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iStockphoto/Thinkstock(NEW YORK) -- When 3-year-old Rozalynn Cevetto has at least two things wrong -- she is hungry, tired, hurt or just not getting her way -- she looks as if she is going to cry but never takes the "big breath."

The first breath-holding incident occurred when Rozalynn was only 14 months old.

"She would start crying, but then appear to take a big breath, but really, she was just sitting there with her mouth agape until she passed out from not breathing," said her mother, Sarah Cevetto, 31, a mother of four from Niles, Ohio.

"It was frightening, at first," she said. "Her eyes would roll back, her lips would turn blue and her face would get really tight."

Cevetto herself was a breath holder when she was little, as was her father. In the 1980s, doctors treated her with medication for seizures, diagnosing her as an epileptic.

But Rozalynn's doctors tell her to just wait, the toddler will outgrow it.

"Breath-holding spells are pretty common in the toddler set," said Ari Brown, an Austin, Texas, pediatrician and author of the book, Toddler 411. "However, they are not harmful in healthy children because if the child actually holds his breath until he passes out, the body's natural mechanism to breathe -- just like when you are sleeping -- kicks in and overrides the child's forced breath-holding."

Even so, many parents and some child psychologists worry that the incidents are not physiological but behavioral, and worry that a child will take advantage of their parents' terror and learn to be manipulative.

Brown estimated "1 in 100 or 1,000, but not 1 in 20,000" children are breath-holders.

The only time these attacks deserve a medical evaluation is if they occur on a regular basis or happen more frequently. A small number of children actually have an iron deficiency that can cause the incidents.

According to the Baby Center, one of the largest online resources for childbirth and parenting, breath-holding spells usually happen in response to pain, fear, frustration, anger or surprise.

Sometimes trauma can trigger an attack. It can happen rarely or up to several times a day. Sometimes, a child will turn blue and behave as if having a seizure. Most outgrow breath-holding by the time they are 8.

"While these spells sometimes occur with tantrums, they're not willful," according to Baby Center. "Your child is not holding her breath on purpose."

Ryan McVay/Thinkstock(OXFORD, England) -- After a review of 69 studies including 143,000 children, researchers say the guidelines for pediatric heart and breathing rate reference ranges should be updated.

Dr. Matthew Thompson of the UK's Oxford University and colleagues suggested new reference ranges that are used for assessing and resuscitating children.

The new reference ranges show that a child's respiratory rate from birth to early adolescence decreases, with the sharpest decline occurring under the age of two. Median breaths per minute fell from 44 at birth to 26 breaths per minute at age two.

The median heart rate in children also climbs from 127 beats per minute at birth to a maximal 145 beats per minute at one month. By age two, the median heart rate decreases to 113 beats per minute, according to the researchers.

The researchers concluded that the guidelines should be changed due to the differences between the existing published guidelines and the findings of their recent review.

"Our centile charts of respiratory rate and heart rate in children provide new evidence-based reference ranges for these vital signs," they wrote in the report published in the March 15 online edition of The Lancet. "We have shown that there is substantial disagreement between these reference ranges, and those currently cited in international pediatric guidelines."

They add that the current reference ranges should be "updated with new thresholds on the basis of our proposed centile charts," particularly in cases where the differences between their charts and the current ranges are so large that many children are not likely classified correctly.